New study confirms incubation period for coronavirus

A new study published yesterday in Annals of Internal Medicine finds that the COVID-19 median incubation period is 5 days, similar to SARS, with 97.5% of patients developing symptoms within 12 days.

The authors confirm that the current period of 14 days of active monitoring is well supported by the evidence. Symptomatic disease is frequently associated with transmissibility of a pathogen. However, given recent evidence of SARS-CoV-2 transmission by mildly symptomatic and asymptomatic persons, we note that time from exposure to onset of infectiousness (latent period) may be shorter than the incubation period estimated here, with important implications for transmission dynamics.

Although the study results support current proposals for the length of quarantine or active monitoring of persons potentially exposed to SARS-CoV-2, longer monitoring periods might be justified in extreme cases. Among those who are infected and will develop symptoms, the authors expect 101 in 10 000 (99th percentile, 482) will do so after the end of a 14-day monitoring period, and the analyses do not preclude this estimate from being higher.

Although it is essential to weigh the costs of extending active monitoring or quarantine against the potential or perceived costs of failing to identify a symptomatic case, there may be high-risk scenarios (for example, a health care worker who cared for a COVID-19 patient while not wearing personal protective equipment) where it could be prudent to extend the period of active monitoring.

The outcomes of this study aim to help public health officials to set rational and evidence-based COVID-19 control policies.

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